Sexual and Reproductive Health

HIV/STI Risk Assessment and Reduction

Methods, Tools and Resources

Wait and verify. Avoid vaginal and anal intercourse with new partners until you have both been tested for STIs. Oral sex is less risky, but use a latex condom or dental dam — a thin, square piece of rubber made with latex or silicone — to prevent direct contact between the oral and genital mucous membranes. Keep in mind that human papillomavirus (HPV) screening isn't available for men, and no good screening test exists for genital herpes, so you may not be aware you're infected until you have symptoms. It's also possible to be infected with an STI yet still test negative.

Use condoms and dental dams consistently and correctly. Use a new latex condom or dental dam for each sex act, whether oral, vaginal or anal. Never use an oil-based lubricant, such as petroleum jelly, with a latex condom or dental dam. Keep in mind that while condoms reduce your risk of exposure to most STIs, they provide a lesser degree of protection for STIs involving exposed genital sores, such as human papillomavirus (HPV) or herpes. Also, nonbarrier forms of contraception, such as oral contraceptives or intrauterine devices, don't protect against STIs.

Don't drink alcohol excessively or use drugs.

Avoid anonymous, casual sex.

Communicate. Before any serious sexual contact, communicate with your partner about practicing safer sex. Reach an explicit agreement about what activities will and won't be OK.

Consider male circumcision. There's evidence that male circumcision can help reduce a man's risk of acquiring HIV from an infected woman (heterosexual transmission) by 50 to 60 percent. Male circumcision may also help prevent transmission of genital HPV and genital herpes.

Consider the drug Truvada. In July 2012, the Food and Drug Administration (FDA) approved the use of the drug Truvada (a fixed dose combination of emtricitabine/tenofovir disoproxil fumarate) to reduce the risk of sexually transmitted HIV infection in those who are at high risk. Truvada is also used as an HIV treatment along with other medications. When used to help prevent HIV infection, Truvada is only appropriate if your doctor is certain you don't already have an HIV or hepatitis B infection. The drug must also be taken daily, exactly as prescribed. And it should only be used along with other prevention strategies such as condom use every time you have sex. Truvada isn't for everyone. If you're interested in Truvada, talk with your doctor about the potential risks and benefits and whether it's right for you.